Fetal growth, length of gestation, and polycystic ovaries in adult life

Cresswell, Janet; Barker, David J.; Osmond, Clive; Egger, P.; Phillips, David I. W.; Fraser, Robert

doi:10.1016/s0140-6736(97)06062-5

Cited by 217 publications

(123 citation statements)

References 21 publications

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“…Intriguingly, longitudinal studies have shown that adolescent serum androgen levels may be preserved into adulthood and are associated with menstrual dysfunction, which suggests a potential risk to develop PCOS (30). A study performed in a large cohort women with PCOS, to investigate the relationship between the prevalence of PCOm and blood androgen levels with the women's body size at birth and the length of gestation, found that the PCOS group characterized by obesity and high testosterone had above-average birth weight and were born from overweight mothers, which suggests that intrauterine factors may in some way predispose to the development of PCOS (31). At variance, a more recent large study did not support the hypothesis that maternal androgens, within the normal range for pregnancy, directly program PCOS in the offspring (32).…”

Section: Arguments In Favor Of the Definition Of Secondary Pcosmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

Pasquali

Diamanti-Kandarakis

Gambineri

2016

European Journal of Endocrinology

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PCOS is a clinical heterogeneous entity of female androgen excess diagnosed by exclusion of other disorders responsible for androgen excess. The concept of secondary PCOS implies that there is a primary well-defined cause leading to the PCOS phenotype with underlying androgen overproduction, regardless of the origin. In these cases, we presume the term of 'secondary PCOS' could be used. In all these conditions, the potential complete recovery of the hyperandrogenemic state as well as the remission of the PCOS phenotype should follow the removal of the cause. If accepted, these concepts could help clinicians to perform in-depth investigations of the potential factors or disorders responsible for the development of these specific forms of secondary PCOS. Additionally, this could contribute to develop further research on factors and mechanisms involved in the development of the classic and the nonclassic PCOS phenotypes. Invited author's profileRenato Pasquali is full professor of Endocrinology & Metabolism and Director of the division of Endocrinology of the S.Orsola-Malpighi Hospital, Bologna, Italy. He also heads the School of Specialization in Endocrinology and Metabolism, University Alma Mater Studiorum of Bologna, Italy. He is a member of numerous national and international scientific societies and serves on the editorial boards of international journals. His scientific interests relate to (i) the pathophysiology and treatment of the polycystic ovary syndrome; (ii) the endocrinology of obesity (sex hormones, the hypothalamic-pituitary-adrenal axis, and the endocannabinoid system).

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Section: Arguments In Favor Of the Definition Of Secondary Pcosmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

Pasquali

Diamanti-Kandarakis

Gambineri

2016

European Journal of Endocrinology

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“…61 Notably however, intrauterine growth retardation at low birth weight has been linked to an increased risk of PCOS in adolescents and adults. 25,62 On the other hand, a survey of a large population in the north of Finland concluded that there was no association between birth weight and symptoms of PCOS in adolescents and adults. 63 For the time being then, it is important to keep an open mind about the possible non-genetic, intrauterine factors that could impact on development of PCOS.…”

Section: Introductionmentioning

confidence: 99%

Polycystic ovary syndrome in adolescents

2008

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Background: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in women and typically presents during adolescence. The clinical and biochemical presentation is heterogeneous, but elevated serum concentrations of androgens are the most consistent biochemical abnormality and may be considered to be the hallmark of the syndrome. Many women with PCOS also have insulin resistance and hyperinsulinaemia, which may contribute to the clinical and endocrine abnormalities. The aetiology of PCOS is not clear but studies in the Rhesus monkey suggest that exposure to excess androgen during intrauterine life results in many of the features of human PCOS, including ovarian dysfunction, abnormal LH secretion and insulin resistance. Objective: To review the studies from the literature, including those of the author, regarding aetiology, presentation and management of PCOS in adolescents. Results and conclusions: We have proposed that PCOS in adolescents arises as a result of a genetically determined disorder of ovarian function that results in hyper-secretion of androgens, possibly during fetal life and also during physiological activation of the hypothalamic-pituitary-ovarian in infancy and at the onset of puberty. There is plentiful evidence for a genetic basis for PCOS (it appears to be a complex endocrine disorder resulting from the effects of a several genes), but environmental factors, notably nutrition, influence the clinical and biochemical phenotype. Obesity unmasks or amplifies symptoms, endocrine and metabolic abnormalities. The increasing incidence of childhood obesity has resulted in an alarming Increase not only in distressing symptoms but also impaired glucose tolerance and even diabetes among adolescent girls with PCOS. The search for PCOS genes in this condition, that is not only heterogeneous but also presents only in women of reproductive age, is not straightforward and has produced few convincing candidates so far. In due course, however, identification of the major susceptibility loci is likely to provide key insight into the aetiology of the syndrome and improve diagnosis and management.

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“…Epidemiological studies have resulted in estimates of prevalence, in women of reproductive age, that range from 6.5% to 8% using biochemical and/or clinical evidence, [4][5][6][7] and ultrasound-based studies have reported a prevalence of 20% or more. [8][9][10][11] Therefore, in a population of seven million Canadian women aged between 15 and 44 years, as many as 1.4 million women may be afflicted with this disorder. 12 It has been our experience that many, if not most, women are first given a diagnosis of PCOS when they present to a reproductive endocrinologist with infertility, and that in the years following last delivery and continuing to reproductive senescence there is a clear tendency to forgo long-term management of symptoms.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Criteria for Polycystic Ovary Syndrome: Pitfalls and Controversies

Lujan

Chizen

Pierson

2008

Journal of Obstetrics and Gynaecology Canada

148

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It is estimated that as many as 1.4 million Canadian women may be afflicted with polycystic ovary syndrome (PCOS). Although PCOS is heralded as one of the most common endocrine disorders occurring in women, its diagnosis, management, and associated long-term health risks remain controversial. Historically, the combination of androgen excess and anovulation has been considered the hallmark of PCOS. To date, while these symptoms remain the most prevalent among PCOS patients, neither is considered an absolute requisite for the syndrome. Inclusion of ultrasonographic evidence of polycystic ovaries as a diagnostic marker has substantially broadened the phenotypic spectrum of PCOS, yet much debate surrounds the validity of these newly identified milder variants of the syndrome. Difficulty in resolving the spectrum of PCOS stems from the continued use of inconsistent and inaccurate methods of evaluating androgen excess, anovulation, and polycystic ovaries on ultrasound. At present, there is no clear-cut definition of biochemical hyperandrogenemia, particularly since we depend on poor laboratory standards for measuring androgens in women. Clinical signs of hyperandrogenism are ill-defined in women with PCOS, and the diagnosis of both hirsutism and polycystic ovarian morphology remains alarmingly subjective. Lastly, there is an inappropriate tendency to assign ovulatory status solely on the basis of menstrual cycle history or poorly timed endocrine measurements. In this review, we elaborate on these limitations and propose possible resolutions for clinical and research settings. By stimulating awareness of these limitations, we hope to generate a dialogue aimed at solidifying the evaluation of PCOS in Canadian women.

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Fetal growth, length of gestation, and polycystic ovaries in adult life

Cited by 217 publications

References 21 publications

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

Polycystic ovary syndrome in adolescents

Diagnostic Criteria for Polycystic Ovary Syndrome: Pitfalls and Controversies

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